Circulation, Vol 86, 803-811, Copyright © 1992 by American Heart Association
JT Salonen, K Nyyssonen, H Korpela, J Tuomilehto, R Seppanen and R Salonen
BACKGROUND. Iron can induce lipid peroxidation in vitro and in vivo in
humans and has promoted ischemic myocardial injury in experimental animals.
We tested the hypothesis that high serum ferritin concentration and high
dietary iron intake are associated with an excess risk of acute myocardial
infarction. METHODS AND RESULTS. Randomly selected men (n = 1,931), aged
42, 48, 54, or 60 years, who had no symptomatic coronary heart disease at
entry, were examined in the Kuopio Ischaemic Heart Disease Risk Factor
Study (KIHD) in Eastern Finland between 1984 and 1989. Fifty-one of these
men experienced an acute myocardial infarction during an average follow-up
of 3 years. On the basis of a Cox proportional hazards model adjusting for
age, examination year, cigarette pack-years, ischemic ECG in exercise test,
maximal oxygen uptake, systolic blood pressure, blood glucose, serum
copper, blood leukocyte count, and serum high density lipoprotein
cholesterol, apolipoprotein B, and triglyceride concentrations, men with
serum ferritin greater than or equal to 200 micrograms/l had a 2.2- fold
(95% CI, 1.2-4.0; p less than 0.01) risk factor-adjusted risk of acute
myocardial infarction compared with men with a lower serum ferritin. An
elevated serum ferritin was a strong risk factor for acute myocardial
infarction in all multivariate models. This association was stronger in men
with serum low density lipoprotein cholesterol concentration of 5.0 mmol/l
(193 mg/dl) or more than in others. Also, dietary iron intake had a
significant association with the disease risk in a Cox model with the same
covariates. CONCLUSIONS. Our data suggest that a high stored iron level, as
assessed by elevated serum ferritin concentration, is a risk factor for
coronary heart disease.
ARTICLES
High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men
Research Institute of Public Health, University of Kuopio, Finland.
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J. L. Sullivan, A. Ascherio, E. B. Rimm, E. Giovannucci, W. C. Willett, and M. J. Stampfer Blood Donation Without Adequate Iron Depletion: An Invalid Test of the Iron Hypothesis Circulation, December 11, 2001; 104 (24): e149 - e149. [Full Text] [PDF]
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S. Kiechl, J. Willeit, A. Ascherio, E. B. Rimm, E. Giovannucci, W. C. Willett, and M. J. Stampfer Ongoing Controversies Surrounding the Vascular Benefits of Blood Donation Response Circulation, October 30, 2001; 104 (18): e99 - e99. [Full Text] [PDF]
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E. Dewailly, C. Blanchet, S. Lemieux, L. Sauve, S. Gingras, P. Ayotte, and B. J. Holub n-3 Fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik Am. J. Clinical Nutrition, October 1, 2001; 74(4): 464 - 473. [Abstract] [Full Text] [PDF]
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M. Haidari, E. Javadi, A. Sanati, M. Hajilooi, and J. Ghanbili Association of Increased Ferritin with Premature Coronary Stenosis in Men Clin. Chem., September 1, 2001; 47(9): 1666 - 1672. [Abstract] [Full Text] [PDF]
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S. Kurl, J. A. Laukkanen, R. Rauramaa, T. A. Lakka, J. Sivenius, and J. T. Salonen Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke Stroke, September 1, 2001; 32(9): 2036 - 2041. [Abstract] [Full Text] [PDF]
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S. B. Dent, C. T. Peterson, L. D. Brace, J. H. Swain, M. B. Reddy, K. B. Hanson, J. G. Robinson, and D. L. Alekel Soy Protein Intake by Perimenopausal Women Does Not Affect Circulating Lipids and Lipoproteins or Coagulation and Fibrinolytic Factors J. Nutr., September 1, 2001; 131(9): 2280 - 2287. [Abstract] [Full Text] [PDF]
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D. J Fleming, P. F Jacques, J. M Massaro, R. B D'Agostino Sr, P. W. Wilson, and R. J Wood Aspirin intake and the use of serum ferritin as a measure of iron status Am. J. Clinical Nutrition, August 1, 2001; 74(2): 219 - 226. [Abstract] [Full Text] [PDF]
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J. A. Laukkanen, S. Kurl, T. A. Lakka, T.-P. Tuomainen, R. Rauramaa, R. Salonen, J. Eranen, and J. T. Salonen Exercise-induced silent myocardial ischemia and coronary morbidity and mortality in middle-aged men J. Am. Coll. Cardiol., July 1, 2001; 38(1): 72 - 79. [Abstract] [Full Text] [PDF]
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S. J. Duffy, E. S. Biegelsen, M. Holbrook, J. D. Russell, N. Gokce, J. F. Keaney Jr, and J. A. Vita Iron Chelation Improves Endothelial Function in Patients With Coronary Artery Disease Circulation, June 12, 2001; 103(23): 2799 - 2804. [Abstract] [Full Text] [PDF]
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S. Voutilainen, T. H. Rissanen, J. Virtanen, T. A. Lakka, and J. T. Salonen Low Dietary Folate Intake Is Associated With an Excess Incidence of Acute Coronary Events : The Kuopio Ischemic Heart Disease Risk Factor Study Circulation, June 5, 2001; 103(22): 2674 - 2680. [Abstract] [Full Text] [PDF]
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 P. Whittaker, P. R. Tufaro, and J. I. Rader Iron and Folate in Fortified Cereals J. Am. Coll. Nutr., June 1, 2001; 20(3): 247 - 254. [Abstract] [Full Text] [PDF]
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J. W. Choi, S. K. Kim, and S. H. Pai Changes in Serum Lipid Concentrations during Iron Depletion and after Iron Supplementation Ann. Clin. Lab. Sci., April 1, 2001; 31(2): 151 - 156. [Abstract] [Full Text] [PDF]
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J. A. Laukkanen, T. A. Lakka, R. Rauramaa, R. Kuhanen, J. M. Venalainen, R. Salonen, and J. T. Salonen Cardiovascular Fitness as a Predictor of Mortality in Men Arch Intern Med, March 26, 2001; 161(6): 825 - 831. [Abstract] [Full Text] [PDF]
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J. Beard Iron status of free-living elderly individuals Am. J. Clinical Nutrition, March 1, 2001; 73(3): 503 - 504. [Full Text] [PDF]
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S. Samman, B. Sandstrom, M. B. Toft, K. Bukhave, M. Jensen, S. S Sorensen, and M. Hansen Green tea or rosemary extract added to foods reduces nonheme-iron absorption Am. J. Clinical Nutrition, March 1, 2001; 73(3): 607 - 612. [Abstract] [Full Text] [PDF]
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D. J Fleming, P. F Jacques, K. L Tucker, J. M Massaro, R. B D'Agostino Sr, P. W. Wilson, and R. J Wood Iron status of the free-living, elderly Framingham Heart Study cohort: an iron-replete population with a high prevalence of elevated iron stores Am. J. Clinical Nutrition, March 1, 2001; 73(3): 638 - 646. [Abstract] [Full Text] [PDF]
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A. Ascherio, E. B. Rimm, E. Giovannucci, W. C. Willett, and M. J. Stampfer Blood Donations and Risk of Coronary Heart Disease in Men Circulation, January 2, 2001; 103(1): 52 - 57. [Abstract] [Full Text] [PDF]
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E. Rossi, B. M. McQuillan, J. Hung, P. L. Thompson, C. Kuek, and J. P. Beilby Serum Ferritin and C282Y Mutation of the Hemochromatosis Gene as Predictors of Asymptomatic Carotid Atherosclerosis in a Community Population Stroke, December 1, 2000; 31(12): 3015 - 3020. [Abstract] [Full Text] [PDF]
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M. Mayer Association of Serum Bilirubin Concentration with Risk of Coronary Artery Disease Clin. Chem., November 1, 2000; 46(11): 1723 - 1727. [Abstract] [Full Text] [PDF]
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Z. K Roughead and J. R Hunt Adaptation in iron absorption: iron supplementation reduces nonheme-iron but not heme-iron absorption from food Am. J. Clinical Nutrition, October 1, 2000; 72(4): 982 - 989. [Abstract] [Full Text] [PDF]
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 L. T. Goodnough, B. Skikne, and C. Brugnara Erythropoietin, iron, and erythropoiesis Blood, August 1, 2000; 96(3): 823 - 833. [Abstract] [Full Text] [PDF]
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 A. Davalos, J. Castillo, J. Marrugat, J. M. Fernandez-Real, A. Armengou, P. Cacabelos, and R. Rama Body iron stores and early neurologic deterioration in acute cerebral infarction Neurology, April 25, 2000; 54(8): 1568 - 1574. [Abstract] [Full Text] [PDF]
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H.-M. Lakka, T. A. Lakka, J. Tuomilehto, J. Sivenius, and J. T. Salonen Hyperinsulinemia and the Risk of Cardiovascular Death and Acute Coronary and Cerebrovascular Events in Men: The Kuopio Ischaemic Heart Disease Risk Factor Study Arch Intern Med, April 24, 2000; 160(8): 1160 - 1168. [Abstract] [Full Text] [PDF]
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P. J. Garry, W. C. Hunt, and R. N. Baumgartner Effects of Iron Intake on Iron Stores in Elderly Men and Women: Longitudinal and Cross-Sectional Results J. Am. Coll. Nutr., April 1, 2000; 19(2): 262 - 269. [Abstract] [Full Text] [PDF]
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M. A. Mansoor, C. Bergmark, S. J. Haswell, I. F. Savage, P. H. Evans, R. K. Berge, A. M. Svardal, and O. Kristensen Correlation between Plasma Total Homocysteine and Copper in Patients with Peripheral Vascular Disease Clin. Chem., March 1, 2000; 46(3): 385 - 391. [Abstract] [Full Text] [PDF]
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J. Willeit, S. Kiechl, F. Oberhollenzer, G. Rungger, G. Egger, E. Bonora, M. Mitterer, and M. Muggeo Distinct Risk Profiles of Early and Advanced Atherosclerosis : Prospective Results From the Bruneck Study Arterioscler Thromb Vasc Biol, February 1, 2000; 20(2): 529 - 537. [Abstract] [Full Text] [PDF]
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